Assessment of parental awareness about pediatric visual problems by Knowledge-Attitude-Practice survey in South India

Purpose: To find out parents’ knowledge, attitude, and treatment practice (KAP) toward pediatric eye problems and to assess the effect of demographic factors such as gender, age, educational status, and number of children on KAP. Methods: A cross?sectional descriptive study was conducted in a hospital setting. Two hundred parents were randomly selected for the questionnaire. All parents had children who were included in Systematic Pediatric Eye Care Through Sibling Screening Strategies (SPECSSS) study. A survey with 15 questions on KAP of pediatric eye diseases was prepared and administered to parents coming to a tertiary eye hospital with varied experience and education qualifications. Results: The mean age of 200 patients was 9.6 (3.4) years, with the majority of them male (n = 110; 55.0%). The majority of the children (n = 91, 45.5%) were between the age group of 6–10 years. Knowledge of visual problems among parents was of a good grade in 9% only. The attitude of the parents toward the visual problem was positive at 17%, and the responses regarding the practice were of excellent grade at 46.5% and good at 26.5%. Analysis suggests that the level of knowledge and practice were not significantly associated with the demographic factors (p > 0.05). The positive attitude toward the visual problems of the children was associated with education of the parents (p < 0.05) and the father occupation (p < 0.05). Conclusion: Knowledge about pediatric eye diseases was poor among parents and it was significantly affected by education and occupation of parents. The parents have positive attitude toward enhancing their attitude in treatment.

Identification of potential barriers for timely access to pediatric sibling eye check-up in a tertiary eye care hospital

Purpose: To identify socio?economic, demographic, and clinical factors that may be associated with sibling access to ophthalmic check?up. Methods: A cross?sectional, descriptive study investigated children in the age group of 0–15 years under a project on Systematic Pediatric Eye Care Through Sibling Screening Strategies (SPECSSS project). The siblings of pediatric patients (proband) with refractive errors, strabismus, cataract, glaucoma, and retinal pathologies were given a referral card for ophthalmic check?up. If parents do not bring siblings for check?up within 1 month of initial information and even after 2 SMS reminders, it was considered as failure to uptake of services. On follow?up later, they were provided a questionnaire. A questionnaire was given to the parent by interview through a project coordinator, and details were obtained from the parents or caretaker. Parents who were willing for telephonic interview were asked to respond to the questionnaire over phone on the scheduled date. The sibling details, parent?related details, and data from questionnaire forms were entered and analyzed. Results: The mean age of 300 siblings was 9.3 ± 4.0 years with the majority of them being female (158). The most common reasons quoted by parents in the rural area compared with the urban area for not bringing siblings for eye exams were the travel distance from home to the hospital (n = 118, 83.7%), the travel time from home to the hospital (n = 109, 77.3%), more than one vehicle required to change (n = 111, 78.7%), and the transportation cost more than rupees 100 (INR) (n = 89, 63.1%) (p < 0.05). Unable to leave work responsibilities (n = 126, 79.3%) was stated more frequently by urban parents compared to rural (p = 0.039). Conclusion: Our study suggests that the financial factor, the distance factor, and social belief play an important role in timely uptake of sibling eye check?up. Targeting siblings with treatable pediatric eye diseases could help in reducing the burden of refractive error, strabismus, and cataract in the pediatric population.

Hypercalcemia and metastatic calcification in a neonate with subcutaneous fat necrosis.

We report a 30-day-old baby with subcutaneous fat necrosis and symptomatic hypercalcemia, who developed metastatic calcification in the subcutaneous tissue, kidneys, pericardium and brain. The baby also had anemia, hypertriglyceridemia and hypercholesterolemia. He was managed with intravenous saline, furosemide, oral steroids and bisphosphonates and improved with treatment.

Hemoglobin level as a risk factor for lower respiratory tract infections.

OBJECTIVE: This prospective study was conducted to evaluate the role of hemoglobin level, as a risk factor for Lower Respiratory Tract Infections in children (LRTI). METHODS: 100 children who came to the outpatient department for LRTI were included in the study. Age and sex-matched 100 children, not having any respiratory illness, were taken as control. They were subjected to complete blood count (CBC),C-reactive protein estimation (CRP), Mantoux test and X-ray chest. Peripheral smear, serum ferritin and serum iron binding capacity were done for all anemic children. Results. Radiological evidence of pneumonia was present in 63 children(63%).Hyper inflated lungs were seen in 27 (27%). Mantoux was positive in 22 children (22%) of study group and none among control group. CRP > 6 mg/L was noted in 45 children (45%) of study group and 14 (14%) of control group. Seventy four of study group (74 %) and 33 of control group (33%) had anemia. Of the anemic children, 60 (60%) had iron deficiency,10 (10%) chronic inflammation and 4 (4%) had hemolytic anemia. These values were 30 (30%), 2 (2%) and 1 (1%)respectively for control group. Low hemoglobin level due to whatever etiology, was a risk factor (p=0.000). CONCLUSION: Anemic children were 5.75 times more susceptible to LRTI compared to the control group. Prevention of anemia, due to whatever etiology, will reduce the incidence of LRTI.

Massive gastrointestinal bleeding in a patient with AIDS.

Cytomegalovirus enteritis can lead to gastrointestinal bleeding in patients with the acquired immune deficiency syndrome. The commonest site of involvement is the colon, followed by the stomach and terminal ileum. Most of these lesions can be diagnosed by colonoscopy or gastroscopy. We present our experience of a patient with cytomegalovirus infection involving only the proximal jejunum causing massive lower gastrointestinal bleeding. Conventional endoscopy and imaging had failed to locate the source of bleeding. Enteroscopy performed at the time of laparotomy showed an ulcerated lesion in the jejunum. Resection followed by histological examination of the resected area confirmed the diagnosis of cytomegalovirus infection. In addition to highly active antiretroviral therapy, ganciclovir was given for 14 days in a dose of 5 mg/kg twice a day and tapered over a period of 3 months. There has been no further episode of gastrointestinal bleeding over a follow up of 9 months.

Paucibacillary leprosy: a comparative study of different schedules of multidrug therapy.

The study was undertaken to evaluate the efficacy of various multidrug regimens (MDT). Three groups of 10 cases each of Paucibacillary cases were given different schedule of multidrug therapy. First group (T-0) was administered modified WHO regimen consisting of Rifampicin 600 mg once a month, Clofazimine 100 mg alternate days and Dapsone 100 mg daily for 6 months. In second group (T-1) Rifampicin 600 mg was given daily for 6 weeks and in third group (T-2) Rifampicin 600 mg was given daily for 6 months. In both the latter groups Clofazimine 100 mg on alternate days and Dapsone 100 mg daily was also administered for 6 months. Objective clinical scoring was done at the time of admission, three months and six months after treatment in all three groups. The best results were obtained by T-2 followed by T-1; and least effective was T-0 regimen. Pinkish colour of urine and skin was observed in 26 cases and icthyosis in all the cases. All the patients remain under treatment. The work is in progress and subsequent results will be published later.